Do Meniscus Tears Need Surgery?

Meniscus tears are one of the most common knee injuries, affecting both athletes and older adults alike. But do all meniscus tears require surgery? The short answer is: not always. The treatment path depends on several factors, including the type of tear, your age, activity level, and overall joint health. This article breaks down when surgery is necessary, when it isn’t, and how to return to full strength safely.

Do All Meniscus Tears Need Surgery?

Not every meniscus tear requires surgery. In fact, many respond well to a structured rehabilitation program that focuses on reducing pain, restoring mobility, and strengthening the surrounding muscles.

Tears That Often Don’t Need Surgery:

• Degenerative tears: Common in adults over 40, these are usually caused by wear and tear rather than trauma. They often respond well to conservative management.

• Small stable tears: If the tear is on the outer edge (the “red zone” with good blood supply) and not causing locking or instability, rehab is usually effective.

• Horizontal and oblique tears: These can often be managed with strength training and progressive loading.

Tears That May Require Surgery:

• Bucket-handle tears: These can cause the knee to lock, requiring arthroscopic surgery to remove or repair the displaced fragment.

• Complex or displaced tears: Particularly those involving instability, catching, or pain unresponsive to rehab.

• Acute traumatic tears in young athletes: If the goal is returning to cutting, pivoting sports, surgery may be the best option.

Rehab vs. Surgery: What Does the Evidence Say?

Several studies, including high-level randomized controlled trials, have shown no long-term advantage of surgery over physical therapy in many cases of degenerative meniscal tears. In fact, meniscectomy (removal of part of the meniscus) may increase the risk of osteoarthritis in the long term.

A well-structured rehab program can restore strength, mobility, and function without the risks of surgery, provided the tear is stable and symptoms are manageable.

FAQs

Q: How long does it take to recover from a meniscus tear without surgery?

A: Most people see significant improvement within 6–12 weeks with targeted rehab. Full return to sport may take 3–4 months depending on severity and goals.

Q: What are signs I might need surgery?

A: Persistent locking, catching, or giving way of the knee, or no improvement after 3 months of rehab, may indicate surgical intervention is needed.

Q: Can you walk with a meniscus tear?

A: Yes, many people can walk with a torn meniscus, though pain, swelling, and reduced range of motion are common.

Q: Is it bad to leave a torn meniscus untreated?

A: Untreated tears, especially unstable or displaced ones, can worsen and increase the risk of long-term joint damage. However, many stable tears heal or become asymptomatic with proper rehab.

Q: Can a torn meniscus heal on its own?

A: Tears in the outer third of the meniscus (the red zone) have good blood supply and may heal naturally. Inner tears typically do not heal on their own but may still become symptom-free with rehab.

Summary

Not all meniscus tears need surgery. Age, type of tear, symptoms, and activity level all influence the best treatment route. At Poseidon Performance, we specialise in helping people recover from meniscus injuries without surgery whenever possible — through structured rehab, targeted strength work, and expert movement coaching.